HPV vaccination: How the world can eliminate cervical cancer

I think it’s funny how in the US the vaccine schedule says not to get the HPV vaccine if you’re over 45. That means that insurance won’t cover it and I even struggle finding a doctor who will administer it because it goes against the guidelines.

The rationale is that if you’re 45, you probably already have HPV. But that assumes that you’ve been sexually active all that time. It doesn’t take into account people who were monogamous until their 50s and then started having sex with new partners.

I really wish we had therapeutic vaccines against HPV. As a man, I always got told "it's not for men", followed by "it is also for men, but only if you never had sex", followed by "it's also for men who had sex, but only to a limited age".

As a male who meets all the criteria to be in a high risk group for HPV throat cancer, and who is dealing with a persistent HPV infection (as proved by warts that won't go away), I'm really sad that I may one day at a young age get cancer in my throat, and there is nothing I can do about it to prevent it. I wish we would put the same amount of energy into inventing vaccines that suppress the virus, or help the body to get rid of them.

The HPV vaccine has been a universal win for this generation. Screening (pap smear) is also highly effective, but requires constant effort.

The remaining gaps in screening and vaccine uptake reflect broader lack of health-care capabilities that won't be solved with pushing the HPV vaccine alone. Changing from injectable to oral could help, but isn't on the table, and local populations and governments are likely to become increasingly resistant to outsiders waving their science authorities, particularly on family matters.

Both authors are Phd's working in outreach - i.e., they seem to have no experience with deploying HPV campaigns.

I remember when Gardasil was first introduced and the related controversy. I believe there were questions about its safety because at first it was targeted at 12 year old females. At one point the Japanese Ministry of Health suspended the vaccine and then later resumed it.

For me the explanation of how this vaccine works still confuses me. For example while older people are advised to get Shringix to mitigate the consequences of a reactivated chickenpox virus. Older are advised not to get Gardasil because once you get HPV, the vaccine is ineffective?

https://mainichi.jp/english/articles/20211115/p2a/00m/0op/00...

Personally I am more excited about HPV caused cancers in my throat, anus and penis, because the only cervix I had contact with was my mothers.

I do not understand this focus on women. Just tell the whole story, that your dick can fall off and every straight frat bro will get vaccinated tomorrow.

I am surprised that this study does not mention which vaccines are being used - as they vary by the number of HPV types they protect against.

"Currently there are six licensed HPV vaccines: three bivalent (protect against two types of HPV), two quadrivalent (against four), and one nonavalent vaccine (against nine)" - https://en.wikipedia.org/wiki/HPV_vaccine

The vaccination campaign has solely been target at girls and women. Which is crazy, since boys and men can get cancer from HPV too.

I really don't understand the bias in public health communication here. OWID is making the same mistake again. How are boys supposed to know that they should get the shot, if everybody public health professional fails to tell them?

> HPV is also thought to cause about 95% of anal cancers, 75% of oropharyngeal cancers, 75% of vaginal cancers, 70% of vulvar cancers, and 60% of penile cancers.2 Low-risk or non-oncogenic genotypes (eg, types 6 and 11) cause anogenital warts, low-grade cervical disease, and recurrent respiratory papillomatosis. In the USA, the incidence of oropharyngeal cancer in men now exceeds that of cervical cancer in women, and by 2020 the annual number of HPV-associated oropharyngeal cancers will exceed that of cervical cancers. As a result, it is important to consider ways to expand our HPV prevention efforts to boys and men.

https://www.thelancet.com/journals/lancet/article/PIIS0140-6...

It would be great if I didn't have to pay the equivalent of 2000 USD for the full cycle where I live. Kids get it for free but if you're 30 you're shit out of luck

I was diagnosed and successfully treated for HPV+ oropharyngeal cancer in 2023. My treatment results were almost perfect, from a clinical perspective. I had transoral robotic surgery to remove the tumors in my mouth / throat, neck dissection to remove cancerous and non-cancerous lymph nodes, and radiation to treat the area after cancer was found to have escaped the lymph nodes.

If I were 10-ish years younger, I wouldn't have gotten cancer. I was likely exposed to HPV in my early to mid 20s, where it hid in my tonsils for decades.

In the US, almost anyone under 45 can get vaccinated. Please do. As another comment points out, they protect against multiple strains. It's unlikely you've been exposed to all of them.

While HPV+ head and neck cancers are more easily and more successfully treated than HPV- ones, I do not recommend getting cancer.

From the outside, I look like a normal person of late middle age. The two incision scars I have look like neck folds -- literally no one, including medical personnel outside of the cancer world, notices them.

From the inside, tho:

* Can no longer taste sugar, salt, chocolate, and a host of other, smaller things. Most other things have less taste and pretty much nothing has a flavor after a few bites. For some, this eventually stops -- I'm unlucky. (Radiation destruction of taste buds)

* Significantly decreased saliva to the throat. Cannot eat without some liquid. The saliva that forms is thicker and sometimes causes problems swallowing. Some get this to the mouth and to a larger extreme -- I'm lucky. (Radiation)

* Dental trauma, including teeth extraction / root canal / deep fillings, may cause spontaneous bone tissue death in the jaw. (Radiation)

* Permanent sensation of partial numbness centered around my left ear and cheek. Touching that area produces a pins and needles sensation. (Neck dissection)

* No feeling in a stripe about 1.5" (4cm) wide where the neck dissection scars are. (Neck dissection)

* Changes in speech quality. These are not clinically significant but changed my voice from one people enjoyed listening to (asked to do voice over work, complemented, etc) to just another voice. (Surgery)

* Tinnitus increased significantly and hearing has worsened. I was not given chemo, the normal cause of hearing loss. (Unsure cause)

There's more, but those are some of the highlights. Get vaccinated, get your kids vaccinated, etc.

HPV- head and neck cancers in the US are dropping as people quit smoking. HPV+ are on the rise for now, but will drop as the generations with vaccinations get older.

I'm traveling today, but will look at this later today if anyone has a question to ask.

I recently got the HPV vaccine (along with some other vaccines I didn't get as a child of anti vax parents).

Vaccines are one of the most amazing inventions. The fact that they can eradicate entire categories of diseases and save so many people from suffering and death with such a simple intervention, is truly remarkable.

It makes me very sad that as a society we are failing to simply take what's there. Maybe the biggest flaw of vaccines is that they are so effective that people don't remember how bad these diseases really were, and only know the minor side effects.

Feeling bad for a couple of days instead of getting certain cancers, measles, hepatitis, and many other serious diseases is a great fucking deal. Also had almost no side effects from the hpv vaccine, 10/10 do recommend.

Unfortunately due to postrealist ideology supplanting fact-based reality, 40% of your scheduled elimination of disease will not be taking place as scheduled.

> especially through sex, kissing, or touching

To what extent can it be transmitted via "touching"? And other mechanisms since it says "especially" implying there might be others.

As a man approaching 40 I've never considered this vaccine because I've only ever been (and ever will be) sexually active in any way with my wife, who has been the same with me. Is there any reason to get the vaccine in my situation? I see a lot of comments here that we all should get it, but if it's just sexually transmitted I don't think there's a reason for me to.

I really hope this happens, I'm a little cynical after hoping that we would come together and eradicate COVID 19.

> The virus is also responsible for a large share of other cancers, including anal cancer, penile cancer, vulval cancer, vaginal cancer, and some head and neck cancers.

It would greatly reduce other types of cancer too. Men also benefit from it. Unfortunately the way campaigns market it causes many people to think it benefits ladies only.

Reading about this is fascinating —

Over here they claim HPV is the leading cause of throat cancer (not smoking) - https://www.cdc.gov/cancer/hpv/basic-information.html

Over here is the leading cause of cervical cancers world wide - https://www.cancer.gov/types/cervical/causes-risk-prevention

Then over here:

> Cervical cancer incidence rates decreased by more than half from the mid-1970s to the mid-2000s … in women ages 30-44, rates have increased 1.7% each year from 2012 to 2019.

> Cervical cancer was once one of the most common causes of cancer death for American women. The cervical cancer death rate has dropped by more than half since the mid-1970s

https://www.cancer.org/cancer/types/cervical-cancer/about/ke...

A vaccine for HPV became available in 2006 — https://en.m.wikipedia.org/wiki/HPV_vaccine

So it seems cancer has increased since the introduction of the vaccine. Prior to that it was decreasing.

Further, after reading about HPV generally, there’s no symptoms typically and most forms are not the cancer causing kind. Only certain HPV strains combined with a long term infection (if they estimate 20 years) cause cancer.

IMO there’s a lot of correlation with frankly minimal and confusing causation. Combined with evidence the vaccines aren’t effective at changing the cancer rates at all, seems like a money grab by big pharma to me. “Get vaccinated to avoid this cancer you’re highly unlikely to get and won’t know if you do for 20 years” seems like a stretch…

Sometimes anti-vaxxers will point to the ostensibly high rate of serious adverse events exhibited by study participants in HPV vaccine trials. For example, in the study 'A 9-Valent HPV Vaccine against Infection and Intraepithelial Neoplasia in Women' published in The New England Journal of Medicine in 2015, in which the 9-Valent HPV vaccine was compared to the Quadrivalent version, the rate of serious adverse events was 3.3% and 2.6% respectively. This objection can be dismissed, as the study authors found that 0.0% of those serious adverse events were vaccine related.

Anti-vaxxers also sometimes object to studies like these on the basis that no placebo arm was included, and thus the true safety profile of the vaccine cannot be ascertained, but this can be flatly rejected because, as the study authors point out, '[s]ince HPV vaccination is widely recommended and has been shown to prevent HPV disease related to oncogenic HPV types, the use of a placebo was not considered to be acceptable for ethical reasons.'